Ferruginous (asbestos) bodies in the lungs of rural dwellers, urban dwellers, and patients with pulmonary neoplasms

Our plain-English summary of Ferruginous (asbestos) bodies in the lungs of rural dwellers, urban dwellers, and patients with pulmonary neoplasms, by P.H. Breedin, D.H. Buss (Southern Medical Journal, 1976).

The study

• Authors: P.H. Breedin, D.H. Buss
• Journal: Southern Medical Journal
• Published: 1976;69(4):401-4
• Cited by: 31 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 002264).

Abstract

The lungs of 100 consecutive patients at autopsy and of 24 patients with various pulmonary neoplasms were analyzed for the presence of ferruginous (asbestos) bodies. The population comprised both rural dwellers and urban dwellers, in contrast to previous similar studies involving only urban dwellers. More than 90% of both population groups had ferruginous bodies in their lungs. There was no apparent difference in the incidence or quantity of ferruginous bodies between the group with pulmonary neoplasms and the randomly selected group. These findings raise the possibility of more widespread asbestos dust contamination of environmental air than has been previously thought and indicate that rural as well as urban populations are exposed. The failure to demonstrate more ferruginous bodies in the lungs of patients with pulmonary neoplasms is in accordance with the view that asbestos acts as a cocarcinogen in this regard.

In plain English

The authors examined lung tissue from 100 consecutive adult autopsies, mostly of people from rural and suburban western North Carolina. Anyone with a lung tumor or known occupational asbestos exposure was excluded. They also examined lung specimens from 24 adults with various lung tumors. Tissue was chemically digested, filtered and checked under a light microscope for ferruginous bodies. These are coated fibers that may or may not have an asbestos core, and the core was not identified. Ferruginous bodies were found in 93% of the autopsy group: 91% of city dwellers and 95% of rural-suburban dwellers. More city dwellers than rural dwellers had 50 or more bodies (20% vs 4%). In the tumor group, 22 of 24 patients (92%) had at least one body per 5 gm of lung, and counts were not noticeably different between groups. The authors concluded that the findings raise the possibility of more widespread asbestos dust contamination of air than previously thought. They cautioned that counts were not truly quantitative, that the share of bodies due to asbestos is unknown, and that residence histories were uncertain.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Autopsy (necropsy) series of consecutive adult lungs, compared with surgical and autopsy lung specimens from patients with lung tumors; ferruginous bodies counted by light microscopy after chemical digestion and filtration of lung tissue
• Who was studied: Two groups. The first was 100 consecutive adult autopsy cases, with lung tumors and known occupational asbestos exposure excluded: 70 male and 30 female, 76 white and 24 described as Negro. In this group 44% lived in cities over 100,000 people, 53% in communities under 21,000, and 30% in communities under 5,000. The second was 24 adults with various lung tumors (11 surgical and 13 autopsy specimens; 19 men and 5 women). Both groups were drawn largely from rural and suburban western North Carolina. Study dates are not given.
• Exposure: Ferruginous bodies (fibers coated with iron-protein material) in lung tissue, as a marker of possible environmental, non-occupational asbestos exposure. The fiber type at the core of the bodies was not determined. The authors note that a true asbestos body has an asbestos core, but this cannot easily be told apart from other fibers.
• Main results:
  • Ferruginous bodies were found in the lungs of 93% of the 100 consecutive adult autopsy cases.
  • In the autopsy group, 91% of city dwellers and 95% of rural-suburban dwellers had at least one ferruginous body in 20 gm of lung tissue. The authors found no significant difference in the percent with positive findings.
  • A higher proportion of city dwellers than rural dwellers had 50 or more ferruginous bodies (20% vs 4%). More negative findings were also noted among city dwellers (9% vs 5%).
  • In the group with lung tumors, 22 of the 24 patients (92%) had at least one ferruginous body per 5 gm of lung.
  • The numbers of ferruginous bodies were not noticeably different among the different groups.
  • Five individuals aged 17, 54, 56, 63 and 75 had lived their entire lives in rural communities of 2,500 or fewer people. All of their lung samples contained at least one ferruginous body. Counts ranged from 1 in 10 gm (a 17-year-old student) to 250 in 5 gm (a 63-year-old man who had worked in a woodworking shop).
  • Three children aged 4, 5 and 6, who were not part of the series, also had ferruginous bodies in their lungs. Two of the three had lived in rural communities all their lives.
• The authors' conclusion: The authors concluded that the findings raise the possibility of more widespread asbestos dust contamination of environmental air than previously thought, and indicate that rural as well as urban populations are exposed.
• Limitations the authors state:
  • Counts were not truly quantitative, because fragments of ferruginous bodies were counted as whole bodies, so one body may have been counted more than once.
  • It is unknown what proportion of ferruginous bodies is due to asbestos. Under light microscopy, bodies with asbestos cores look the same as those with other fiber cores, and testing the core was too impractical to do routinely.
  • None of the patients had a positive history of occupational asbestos exposure, but the authors stated that a negative history means little. Many people are unaware of exposures, and exposures may have been brief and long ago.
  • Because the population moves around, living in a rural or suburban community at the final hospital admission did not show that a patient had lived there long.
  • The authors stated it was entirely possible that the ferruginous bodies in rural dwellers came from fibers inhaled during brief visits to urban areas.
  • Many ferruginous bodies are too small to be seen with the light microscope used in this study.
  • The authors stated it is not yet known whether the small amounts of asbestos inhaled by the general population are of any significance.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer.

Medical terms in this study, explained in our Lexicon: Neoplasm, Autopsy, Ferruginous body.

Related studies

• Pulmonary ferruginous bodies in city dwellers. A study of their central fiber — P. Gross, R.T. DeTreville, et al. (1969)
• Fibrous dust particles and ferruginous bodies. Methods for quantitating them and some results from the lungs of city dwellers — P. Gross, J. Tuma, et al. (1970)
• Indoor air quality differences between urban and rural preschools in Korea — C. Yoon, K. Lee, et al. (2011)
• Cancer incidence in urban, rural, and densely populated districts close to core cities in Bavaria, Germany — M. Radespiel-Tröger, K. Geiss, et al. (2018)
• A method for extracting ferruginous bodies from sputum and pulmonary tissue — M.J. Smith, B. Naylor (1972)
• Pulmonary fibrosis and ferruginous bodies associated with exposure to synthetic fibers — A.J. Ghio, W. Funkhouser, et al. (2006)

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